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. 2022 Jun;43(6):714-718.
doi: 10.1017/ice.2021.215. Epub 2021 Jun 4.

Laboratory-identified vancomycin-resistant enterococci bacteremia incidence: A standardized infection ratio prediction model

Sukarma S S Tanwar #  1 , Lindsey M Weiner-Lastinger  1 , Jeneita M Bell  1 , Katherine Allen-Bridson  1 , Suparna Bagchi  1 , Margaret A Dudeck  1 , Jonathan R Edwards  1
Affiliations

Laboratory-identified vancomycin-resistant enterococci bacteremia incidence: A standardized infection ratio prediction model

Sukarma S S Tanwar et al. Infect Control Hosp Epidemiol. 2022 Jun.

Abstract

Background: We analyzed 2017 healthcare facility-onset (HO) vancomycin-resistant Enterococcus (VRE) bacteremia data to identify hospital-level factors that were significant predictors of HO-VRE using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) multidrug-resistant organism and Clostridioides difficile reporting module. A risk-adjusted model that can be used to calculate the number of predicted HO-VRE bacteremia events in a facility was developed, thus enabling the calculation of VRE standardized infection ratios (SIRs).

Methods: Acute-care hospitals reporting at least 1 month of 2017 VRE bacteremia data were included in the analysis. Various hospital-level characteristics were assessed to develop a best-fit model and subsequently derive the 2018 national and state SIRs.

Results: In 2017, 470 facilities in 35 states participated in VRE bacteremia surveillance. Inpatient VRE community-onset prevalence rate, average length of patient stay, outpatient VRE community-onset prevalence rate, and presence of an oncology unit were all significantly associated (all 95% likelihood ratio confidence limits excluded the nominal value of zero) with HO-VRE bacteremia. The 2018 national SIR was 1.01 (95% CI, 0.93-1.09) with 577 HO bacteremia events reported.

Conclusion: The creation of an SIR enables national-, state-, and facility-level monitoring of VRE bacteremia while controlling for individual hospital-level factors. Hospitals can compare their VRE burden to a national benchmark to help them determine the effectiveness of infection prevention efforts over time.

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Conflict of interest statement

Conflicts of interest. All authors report no conflicts of interest relevant to this article.

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